Lesson 4

6. An 80-year-old client has recently been started on cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system (CNS) side effect of this medication?

3. Confusion

4. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists, one of which could be prescribed. Select all that apply.

1. Nizatidine (Axid), 2. Ranitidine (Zantac), 3. Famotidine (Pepcid), 4. Cimetidine (Tagamet).

11. What are likely causes for peptic ulcers? SELECT ALL THAT APPLY

A. H PYLORI, B. NSAIDs, C. Smoking, D. Stress** - All of these are potential causes of peptic ulcers.

8. A nurse is reviewing medications for a client who has a diagnosis of small bowel obstruction. The nurse should withhold Senna (Senoket) prescribed orally based on an understanding of which of the following?

A. Laxatives are contraindicated in clients who have a small bowel obstruction

A client has been taking omeprazole (Prilosec) for 4 weeks. The nurse determines that the client is receiving the optimal intended effect of the medication if the client reports the absence of which of the following symptoms?

B. Heartburn

A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has:

C. Episode of diarrhea** - Loperamide (Imodium) is an antidiarrheal medication used to relieve symptoms of diarrhea.

5. A client with a gastric ulcer has an order for sucralfate (Carafate), 1 g orally four times a day. The nurse schedules the medications for which of the following times?

C. One hour after meals and at bedtime

A nurse teaches a client taking metoclopramide (Reglan) to discontinue the medication immediately and call the physician if which side effect occurs with long-term use?

C. Restlessness or uncontrolled rhythmic movements of the face or limbs.

7. A charge nurse and a newly licensed nurse are providing care for a client who reports nausea and has a prescription for metoclopramide (Reglan) as an antiemetic. Which of the following statements by the newly licensed nurse indicates a correct understanding of the actions of the medication "Metoclopramide"?

D. Promotes gastric emptying

8. What is an LPN's responsibility in the care of a patient receiving TPN?

a. Compare the TPN bag contents with the order** - This is a critical step in ensuring the correct infusion for the patient.

14. What are symptoms of dumping syndrome? SELECT ALL THAT APPLY

a. Drop in blood glucose, b. Diaphoresis, c. Feeling faint** - These are common symptoms of dumping syndrome.

20. A pediatric patient is admitted with suspected appendicitis, and the mother is about to put a moist hot washcloth on her son's belly, expressing concern about pain. What's the best action by the nurse?

a. Explain that heat can cause appendicitis to rupture** - Heat could potentially worsen the condition if it is indeed appendicitis, so it's essential to inform the mother about this.

21. What signs and symptoms are suspicious for appendicitis? SELECT ALL THAT APPLY

a. Fever, b. Pain at McBurney's point** - These are typical signs and symptoms of appendicitis.

6. What test helps to diagnose pernicious anemia?

a. Gastric acid test** - This test is used to diagnose pernicious anemia.

19. A patient is suffering from hemorrhoids. What patient teaching is important? SELECT ALL THAT APPLY

a. High fiber diet, b. Increase water intake, c. Sitz bath** - These are appropriate patient teachings for managing hemorrhoids.

18. A patient wants to know what it means to have a reducible hernia?

a. It can disappear when lying down** - A reducible hernia can often be pushed back into place or disappears when lying down.

13. What are risk factors for GERD? SELECT ALL THAT APPLY

a. Obesity, b. Pregnancy, c. Increase alcohol intake** - These are risk factors for GERD.

12. What are nonpharm interventions for GERD? Select all that apply

a. Small meals, b. Avoid irritants, c. Reduce stress, d. Lower HOB, f. Reduce acidic foods, g. Stay upright after meals

15. How to prevent dumping syndrome? SELECT ALL THAT APPLY

a. Small meals, c. Sit upright after meal** - These measures can help prevent or alleviate dumping syndrome.

5. A patient post colonoscopy wants to know when he can eat. What's the best answer by the nurse?

a. When your gag reflex and bowel sounds return** - This indicates readiness to eat and helps prevent aspiration.

2. A patient is concerned about pale white stools after an upper GI study with contrast. What is the best answer by the nurse?

b. "It is oral contrast leaving your body; increase your fluid intake to help expel it"** - This provides an appropriate explanation and advice to the patient.

10. A patient is suspected to have GI ulcers; he states that abdominal pain is better when eating. What is a likely problem?

b. Duodenal ulcer** - Abdominal pain improving with eating is a characteristic symptom of duodenal ulcers.

17. A patient has been diagnosed with diverticulosis, what foods should be avoided?

c. Avoid seeds and grains** - This is a common dietary recommendation for individuals with diverticulosis.

3. A patient is post upper GI endoscopy complaining of severe abdominal cramps and shoulder pain. On assessment, the abdomen is hard, board-like, and bowel sounds are diminished. What is likely happening?

c. Bowel perforation** - These symptoms are indicative of a serious complication like bowel perforation.

4. What lab work is important to complete before colonoscopy?

c. Coagulation studies (PT/PTT/INR)** - It is important to assess coagulation status before a procedure like a colonoscopy.

9. What patient is at risk for developing a peptic ulcer?

c. Taking NSAIDs for arthritis** - NSAIDs are known to increase the risk of peptic ulcers.

A patient is preparing to do an occult blood stool test. What statement indicates a need for more education?

d. I can eat steak for a medium rare dinner** - This is incorrect as it could interfere with the accuracy of the occult blood stool test.

7. How to confirm initial NG tube placement?

d. Measure the length** - This is the correct method to confirm initial NG tube placement.

16. A patient underwent a partial gastrectomy; he is complaining of a sore tongue and tingling in toes. On assessment, his tongue is red and shiny. What is a likely cause of those symptoms?

d. Vit B12 deficiency** - These symptoms are indicative of a potential vitamin B12 deficiency, which can occur after a partial gastrectomy.